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Pharmacology 381 > Diuretics > Flashcards

Diuretics Flashcards

1
Q

Function of Kidney

A
  • Regulation of water and electrolytes in body
  • Retention of substances vital to the body
  • Maintenance of acid-base reactions
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2
Q

Transcellular movement

A

Through apical and basolateral membranes

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3
Q

Paracellular movement

A

through space between tubular cells

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4
Q

What are diuretics

A

Drugs that increase excretion of sodium and chloride ions> increasing urine volume via action on the kidney. They act on a single zone in the kidney

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5
Q

What do diuretics treat

A

Oedema state, non-oedema state and hypertension

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6
Q

What are the classes of diuretics

A
  • carbonic anhydrase inhibitor
  • Osmotic diuretics
  • Loop diuretics
  • Thiazide diuretics
  • Thiazide-like analogs
  • ADH antagonists
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7
Q

What is oedema

A

Rate of fluid formation exceeds that of reabsorption. NaCl reabsorption too high> water retention

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8
Q

Treating oedematous states

A
  • Cognitive heart failure: reduce ability to maintain cardaic output> increase blood volume
  • Nephrotic syndrome: loss of prot reduces colloidal osmotic pressure
  • Hepatic cirrhosis: Accumu of fluid in abdominal space
  • Premenstrual oedema
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9
Q

Treating non-oedematous states

A
  • hypertension: Reduce BV & dilate arteries
  • Hypercalcaemia: Calcium excretion
  • Diabetes insipidus: Reduce plasma vol, reduce GFR, increase reabsorption of water and sodium
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10
Q

Low ceiling diuretics

A
  • Thiazide: rapid flattening dose effect curve. Not dose dependent
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11
Q

High ceiling diuretics

A
  • Loop diuretics: dose dependent
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12
Q

Carbonic anhydrase inhibitor drug and their MOA

A
  • Acetazolamide
  • inhibits reabsorption of HCO3- in the proximal convoluted tubules
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13
Q

General MOA of carbonic anhydrase inhibitors

A

Inhibits exchange of across the sodium-hydrogen antiporter> inhibition sodium reabsorption> decrease ability to exchange Na+ for H+ in the presence of carbonic anhydrase> results in mild diuresis

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14
Q

Adverse effects of carbonic anhydrase inhibitors

A
  • Acidosis
  • Hypokalaemia
  • Decreased uric acid secretion
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15
Q

Osmotic diuretic drugs and their MOA

A
  • Mannitol, Glucose
  • Increases osmolarity of tubular fluid, preventing water reabsorption> osmotic diuresis
  • targets proximal tubule/ descending loop of Henle
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16
Q

Adverse effects of Osmotic diuretics

A
  • Dehydration
  • headache
17
Q

Loop diuretic drugs and their MOA

A
  • Furosemide, Bumetanide
  • Inhibits cotransport of Na+/K+/2Cl-> decreasing reabsorption of these ions
  • Greatest diuretic effect out of all diuretics
  • targets ascending loop of Henle
18
Q

Indications and adverse effects of loop diuretics

A
  • acute pulmonary oedema, hypertension, hypercalcaemia
  • Ototoxicity, hyperuricaemia, acute hypovolaemia
19
Q

Thiazide diuretic drugs and their MOA

A
  • Hydrochlorothiazide
  • Inhibits reabsorption of Na+ and Cl- in the distal convoluted tubules> water retention in tubules and increased Na+ and Cl- conc in tubular fluid
  • Also reduce peripheral vascular resistance
20
Q

Indications and adverse effects of thiazide diuretics

A
  • Hypertension, mild cognitive heart failure
  • Orthostatic hypotension, erectile disfunction, hypokalaemia
21
Q

Thiazide-like analog drugs and their MOA

A
  • Chlothalidone, metaolzone, indapamide
  • inhibit reabsorption of Na+ and Cl- in distal tubule> water retention ad increased conc of Na+ and Cl- in the tubular fluid
22
Q

Aldosterone antagonistic drugs and their MOA

A
  • Spiranolactone, amiloride, triamterene
  • prevents translocation of the receptor complex into the nucleus of the target cell> failure in production of mediator proteins that normally stimulate the Na+/K+ exchange sites of collecting tubule> K+ and H+ secretion
23
Q

Indication and adverse effects of aldosterone antagonists

A
  • hypertension, heart failure
  • hyperkalaemia, menstrual irregularities, decreases libido
24
Q

ADH antagonistic drugs and their MOA

A
  • Lithium, demeclocycline
  • Decrease aquaporins in collecting ducts> decreasing water reabsorption in the collecting ducts
25
Q

Indication of ADH antagonists

A
  • SIADH
26
Q

Natural diuretic herbs

A
  • parsley
    -holy basil
  • dandelion
27
Q

Natural diuretic fruits and veg

A
  • tomatoes
  • cranberries
  • asparagus

Pharmacology 381 (7 decks)

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